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General NPI Number Information
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NPI Number | 1043790462
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Entity Type | Organization
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Legal Business Name | ISAAK YELIZAR DDS PLLC
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Dates
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Enumeration Date | 08/15/2018
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Last Update Date | 08/15/2018
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Provider Practice Location Address
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Address Line | 63109 SAUNDERS ST STE BA2
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City | REGO PARK
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State | NY
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Zip | 11374-3100
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Country | US
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Telephone | 347-674-7225
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Fax |
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Provider Business Mailing Address
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Address Line | 63109 SAUNDERS ST
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City | REGO PARK
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State | NY
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Zip | 11374-3109
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. ISAAK YELIZAR
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Credential | DDS
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Telephone | 347-674-7225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 055732
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License Number State | NY
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